Abstract
BackgroundDespite access to free antiretroviral therapy (ART) for all people living with human immunodeficiency virus (HIV), noncompliance to treatment continues to be a significant challenge in Eswatini. Yet studies investigating barriers to ART adherence in Eswatini are scarce. Most notably, there is a lack of research regarding rural women in Eswatini, who are currently the country’s most vulnerable to HIV infection. Therefore, the objective of the study is to investigate individual, household, and community level barriers to ART adherence among rural women living with HIV.MethodsWe conducted a qualitative study to investigate individual, household, and community level barriers to ART adherence. We conducted focus group discussions with HIV-infected women (n = 4) from rural villages in Eswatini, and in-depth interviews with healthcare workers (n = 8) serving the area clinics. Open and axial coding techniques were used for data analysis and interpreted within a social ecological framework.ResultsOur findings revealed several individual level barriers including hunger, side effects of ART, personal stress, lack of disclosure of HIV status, alcohol use, and forgetting to take ART. Lack of food, unemployment and scarcity of financial resources were identified as critical barriers at the household level. Community and institutional barriers encompassed factors related to health delivery such as lack of privacy, travel time, transportation costs, excessive alcohol use by healthcare workers, maltreatment, public and self-stigma, gossip, and long waits at clinics.ConclusionsRural women living with HIV face multilevel barriers to ART adherence. Support programs aimed at increasing ART adherence among this vulnerable population need to develop targeted polices to alleviate challenges rural women face, beginning with expanding qualifications for food assistance programs.
Highlights
More than four decades into the human immunodeficiency virus (HIV)/AIDS crisis, an estimated 37.9 million people around the world are infected with HIV, with sub-Saharan Africa accounting for 68% of the global burden[1]
Despite access to free antiretroviral therapy (ART) for all people living with human immunodeficiency virus (HIV), noncompliance to treatment continues to be a significant challenge in Eswatini
Rural women living with HIV face multilevel barriers to ART adherence
Summary
More than four decades into the HIV/AIDS crisis, an estimated 37.9 million people around the world are infected with HIV, with sub-Saharan Africa accounting for 68% of the global burden[1]. Poverty has been identified as both a risk factor for HIV transmission and a significant barrier to ART adherence among women in Eswatini[4,5,6]. Women living in poverty in rural settings are at a greater risk due to gender norms and traditional roles (such as limited access to education and financial resources) which often forces them to be dependent on men[4,5,6]. Poverty and gender disparities increase HIV transmission by reducing women’s control over safe sex practices, and may negatively impact HIV-infected women’s access to care and treatment[4,5,6]. The objective of the study is to investigate individual, household, and community level barriers to ART adherence among rural women living with HIV
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
